To be perfectly honest, I was expecting Bethesda to leave survival elements strictly to modders, who no doubt were going to release something similar to Fallout: New Vegas' Hardcore Mode (itself inspired by a Fallout 3 mod) as soon as they got their hands on the GECK modkit.

It's great to hear we're getting an officially supported version, though, and that Bethesda is clearly listening to the players' feedback. And in case Bethesda's own implementation fails to satisfy the most hardcore crowd, I'm sure mods will be out soon to make it even more punishing and complex.